Skip to main content

Severe Combined Immunodeficiency Patients: Immune Recovery After Stem Cell Transplantation

  • Chapter
  • First Online:
Stem Cells and Cancer Stem Cells, Volume 4

Part of the book series: Stem Cells and Cancer Stem Cells ((STEM,volume 4))

Abstract

Severe Combined Immunodeficiency (SCID) is a group of inherited disorders characterized by highly impaired cellular and humoral immunity, which causes an increased risk of persistent opportunistic infections that could be fatal, if untreated, at very early age. The treatment of choice is hematopoietic stem cell transplantation (HSCT) without conditioning from human leukocyte antigen-identical donor siblings; haploidentical parental donors are also successfully used. Several factors, including the type of SCID, transplantation in the neonatal period and lack or proper prevention of graft versus host disease, are associated with a better outcome after transplantation. Moreover, a rapid immune reconstitution is crucial for all patients undergone stem cell transplantation, but while T-cell reconstitution is observed during the first years after HSCT in most patients with SCID, correction of B-cell function is often more problematic. Generally, T-cell immunity recovers within about a year after HSCT, whereas B-cell immunity recovers more slowly.

Measurement of T-cell receptor excision circles (TRECs) in peripheral blood is a mean of thymic T-cell production and it has been used in many studies to estimate thymus-dependent T-cell reconstitution after transplantation. We have recently proposed a new assay that, quantifying simultaneously TRECs and kappa-deleting recombination excision circles, measures the output of T and B cells from the thymus and bone marrow, and we have applied it to immune reconstitution analysis in patients with SCID.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Antoine C, Muller S, Cant A (2003) Long-term survival and transplantation of haematopoietic stem cells for immunodeficiencies: report of the European experience 1968–1999. Lancet 361:553–560

    Article  PubMed  Google Scholar 

  • Borghans JA, Bredius RG, Hazenberg MD, Roelofs H, Jol-van der Zijde EC, Heidt J, Otto SA, Kuijpers TW, Fibbe WE, Vossen JM, Miedema F, van Tol MJ (2006) Early determinants of long-term T-cell reconstitution after hematopoietic stem cell transplantation for severe combined immunodeficiency. Blood 108:763–769

    Article  PubMed  CAS  Google Scholar 

  • Bortin MM, Rimm AA (1977) Severe combined immunodeficiency disease. Characterization of the disease and results of transplantation. JAMA 238:591–600

    Article  PubMed  CAS  Google Scholar 

  • Buckley RH (2004) Molecular defects in human severe combined immunodeficiency and approaches to immune reconstitution. Annu Rev Immunol 22:625–655

    Article  PubMed  CAS  Google Scholar 

  • Buckley RH (2010) B-cell function in severe combined immunodeficiency after stem cell or gene therapy: a review. J Allergy Clin Immunol 125:790–797

    Article  PubMed  CAS  Google Scholar 

  • Buckley RH (2011) Transplantation of hematopoietic stem cells in human severe combined immunodeficiency: longterm outcomes. Immunol Res 49:25–43

    Article  PubMed  Google Scholar 

  • Cavazzana-Calvo M, Carlier F, Le Deist F, Morillon E, Taupin P, Gautier D, Radford-Weiss I, Caillat-Zucman S, Neven B, Blanche S, Cheynier R, Fischer A, Hacein-Bey-Abina S (2007) Long-term T-cell reconstitution after hematopoietic stem-cell transplantation in primary T-cell-immunodeficient patients is associated with myeloid chimerism and possibly the primary disease phenotype. Blood 109:4575–4581

    Article  PubMed  CAS  Google Scholar 

  • Fischer A, Le Deist F, Hacein-Bey-Abina S, André-Schmutz I, de Saint Basile G, de Villartay JP, Cavazzana-Calvo M (2005) Severe combined immunodeficiency. A model disease for molecular immunology and therapy. Immunol Rev 203:98–109

    Article  PubMed  CAS  Google Scholar 

  • Friedrich W, Honig M, Muller SM (2007) Long-term follow-up in patients with severe combined immunodeficiency treated by bone marrow transplantation. Immunol Res 38:165–173

    Article  PubMed  Google Scholar 

  • Fronkova E, Muzikova K, Mejstrikova E, Kovac M, Formankova R, Sedlacek P, Hrusak O, Stary J, Trka J (2008) B-cell reconstitution after allogeneic HSCT impairs minimal residual disease monitoring in children with ALL. Bone Marrow Transplant 42:187–196

    Article  PubMed  CAS  Google Scholar 

  • Gatti RA, Meuwissen HJ, Allen HD, Hong R, Good RA (1968) Immunological reconstitution of sex-linked lymphopenic immunological deficiency. Lancet 2:1366–1369

    Article  PubMed  CAS  Google Scholar 

  • Glanzmann E, Riniker P (1950) Essentielle lymphocytophtose. Ein neues krankeitsbild aus der Sauglingspathologie. Ann Paediatr 174:1–5

    Google Scholar 

  • Haddad E, Landais P, Friedrich W, Gerritsen B, Cavazzana-Calvo M, Morgan G, Bertrand Y, Fasth A, Porta F, Cant A, Espanol T, Müller S, Veys P, Vossen J, Fischer A (1998) Longterm immune reconstitution and outcome after HLA-nonidentical T-cell-depleted bone marrow transplantation for severe combined immunodeficiency: a European retrospective study of 116 patients. Blood 91:3646–3653

    PubMed  CAS  Google Scholar 

  • Haddad E, Le Deist F, Aucouturier P, Cavazzana-Calvo M, Blanche S, de Saint Basile G, Fischer A (1999) Long-term chimerism and B-cell function after bone marrow transplantation in patients with severe combined immunodeficiency with B cells: a single-center study of 22 patients. Blood 94:2923–2930

    PubMed  CAS  Google Scholar 

  • Mazzolari E, Forino C, Guerci S, Imberti L, Lanfranchi A, Porta F, Notarangelo LD (2007) Long-term immune reconstitution and clinical outcome after stem cell transplantation for severe T-cell immunodeficiency. J Allergy Clin Immunol 120:892–899

    Article  PubMed  CAS  Google Scholar 

  • Myers LA, Patel DD, Puck JM, Buckley RH (2002) Hematopoietic stem cell transplantation for severe combined immunodeficiency in the neonatal period leads to superior thymic output and improved survival. Blood 99:872–878

    Article  PubMed  CAS  Google Scholar 

  • Neven B, Leroy S, Decaluwe H, Le Deist F, Picard C, Moshous D, Mahlaoui N, Debre M, Casanova JL, Dal Cortivo L, Madec Y, Hacein-Bey-Abina S, de Saint Basile G, de Villartay JP, Blanche S, Cavazzana-Calvo M, Fischer A (2009) Long-term outcome after hematopoietic stem cell transplantation of a single-center cohort of 90 patients with severe combined immunodeficiency. Blood 113:4114–4124

    Article  PubMed  CAS  Google Scholar 

  • Patel NC, Chinen J, Rosenblatt HM, Hanson IC, Krance RA, Paul ME, Abramson SL, Noroski LM, Davis CM, Seeborg FO, Foster SB, Leung KS, Brown BS, Ritz J, Shearer WT (2009) Outcomes of patients with severe combined immunodeficiency treated with hematopoietic stem cell transplantation with and without preconditioning. J Allergy Clin Immunol 124(1062–1069):e1–e4

    PubMed  Google Scholar 

  • Peggs KS, Krauss AC, Mackall CL (2009) Clinical implications of immune reconstitution following hematopoietic stem cell transplantation. Cancer Treat Res 144:131–154

    Article  PubMed  CAS  Google Scholar 

  • Railey MD, Lokhnygina Y, Buckley RH (2009) Long-term clinical outcome of patients with severe combined immunodeficiency who received related donor bone marrow transplantation without pretransplant chemotherapy or post-transplant GVHD prophylaxix. J Pediatr 155:834–840

    Article  PubMed  Google Scholar 

  • Roberts JL, Lengi A, Brown SM, Chen M, Zhou YL, O’Shea JJ, Buckley RH (2004) Janus kinase 3 (JAK3) deficiency: clinical, immunologic, and molecular analyses of 10 patients and outcomes of stem cell transplantation. Blood 103:2009–2018

    Article  PubMed  CAS  Google Scholar 

  • Routes JM, Grossman WJ, Verbsky J, Laessig RH, Hoffman GL, Brokopp CD, Baker MW (2009) Statewide newborn screening for severe T-cell lymphopenia. JAMA 302:2465–2470

    Article  PubMed  CAS  Google Scholar 

  • Sarzotti-Kelsoe M, Win CM, Parrott RE, Cooney M, Moser BK, Roberts JL, Sempowski GD, Buckley RH (2009) Thymic output, T-cell diversity, and T-cell function in long-term human SCID chimeras. Blood 114:1445–1453

    Article  PubMed  CAS  Google Scholar 

  • Serana F, Sottini A, Chiarini M, Zanotti C, Ghidini C, Lanfranchi A, Notarangelo LD, Caimi L, Imberti L (2010) The different extent of B and T cell immune reconstitution after hematopoietic stem cell transplantation and enzyme replacement therapies in SCID patients with adenosine deaminase deficiency. J Immunol 185:7713–7722

    Article  PubMed  CAS  Google Scholar 

  • Sottini A, Ghidini C, Zanotti C, Chiarini M, Caimi L, Lanfranchi A, Moratto D, Porta F, Imberti L (2010) Simultaneous quantification of recent thymic T-cell and bone marrow B-cell emigrants in patients with primary immunodeficiency undergone to stem cell transplantation. Clin Immunol 136:217–227

    Article  PubMed  CAS  Google Scholar 

  • van Zelm MC, Szczepanski T, van der Burg M, van Dongen JJM (2007) Replication history of B lymphocytes reveals homeostatic proliferation and extensive antigen-induced B cell expansion. J Exp Med 204:645–655

    Article  PubMed  Google Scholar 

  • Wengler GS, Lanfranchi A, Frusca T, Verardi R, Neva A, Brugnoni D, Giliani S, Fiorini M, Mella P, Guandalini F, Mazzolari E, Pecorelli S, Notarangelo LD, Porta F, Ugazio AG (1996) In utero transplantation of parental CD34 haematopoietic progenitor cells in a patient with X-linked severe combined immunodeficiency (SCIDX1). Lancet 348:1484–1487

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Luisa Imberti .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2012 Springer Science+Business Media B.V.

About this chapter

Cite this chapter

Zanotti, C., Caimi, L., Imberti, L. (2012). Severe Combined Immunodeficiency Patients: Immune Recovery After Stem Cell Transplantation. In: Hayat, M. (eds) Stem Cells and Cancer Stem Cells, Volume 4. Stem Cells and Cancer Stem Cells, vol 4. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-2828-8_25

Download citation

Publish with us

Policies and ethics